Anxiety sensitivity cognitive concerns drives the relation between anxiety sensitivity and symptoms of depression

Depression is one of the most common and serious mental illnesses. Indeed, more than 300 million people suffer from depression worldwide. Importantly, depression has various personal and societal consequences, which supports the increasing need for more research to better understand this debilitating disorder.

One of the common misconceptions about depression is that depression is just being sad. In reality, depression is much more than that. There are actually 9 distinct symptoms of depression, of which at least 5 need to be present for at least two consecutive weeks for someone to be diagnosed with a depressive disorder. Research has shown that the symptoms of depression tend to group together, and can be considered cognitive symptoms of depression (e.g., thoughts of worthlessness, inappropriate guilt), affective symptoms of depression (e.g., loss of interest or pleasure), and somatic symptoms of depression (e.g., sleep difficulties, appetite disturbance). Although we know there are these distinct symptom dimensions of depression, there is not much research examining risk factors for these depression dimensions.

One risk factor that is consistently related to depression symptoms is anxiety sensitivity (AS). AS is the fear of anxiety symptoms. AS is composed of three lower-order dimensions; physical concerns (the fear of physical symptoms of anxiety, like elevated heart rate), cognitive concerns (the fear of cognitive dyscontrol, like feeling spacy), and social concerns (the fear of publicly observable anxiety symptoms, like blushing). Of these dimensions, AS cognitive concerns appears to be the most strongly related to depression. However, previous meta-analytic findings suggest that of the AS dimensions, AS physical concerns is as or more strongly related to several somatic symptoms of depression as AS cognitive concerns. Given the inconsistencies in the literature, the current study sought to clarify how the AS dimensions relate to depression symptom dimensions (i.e., cognitive, affective, somatic).

The current study looked at how the AS dimensions relate to depression symptom dimensions in a sample of treatment/research seeking participants. Participants were recruited at an anxiety clinic and completed a diagnostic interview and self-report measures. The participants had elevated psychopathology, with 89.2% having at least one clinical diagnosis and 51.6% having a depression diagnosis.

Analyses were conducted to see how the depression symptoms clustered together. The cognitive symptoms of depression grouped together, and the affective and somatic symptoms of depression grouped together into a single affective/somatic symptom dimension. AS cognitive concerns was significantly related to both the cognitive and affective/somatic symptoms of depression. Neither of the other AS dimensions were significantly related to depression symptom dimensions.

Taken together, these findings suggest AS cognitive concerns drives the relation between AS and depression symptoms. Importantly, these findings may help guide future research efforts and inform treatment options aimed at improving depression symptoms in those who are suffering. For instance, there are interventions designed to reduce AS cognitive concerns. By using AS-reduction interventions in combination with depression symptom dimension-specific treatment, we may be able to reduce the personal and societal cost of depression.

Read the full paper: Saulnier, K. G., Allan, N. P., Raines, A. M., & Schmidt, N. B. (in press). Anxiety sensitivity cognitive concerns drive the relation between anxiety sensitivity and symptoms of depression. Cognitive Behaviour Therapy. doi:10.1080/16506073.2018.1469664

Kevin Saulnier


Photo by: Erik Drost

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